6055-Minium Essential Coverage (MEC)

Requires health insurers (carries0 and sponsors of self-insured health plans to provide covered individuals and the IRS with information on MEC for a calendar year (CY). Information in this report is used to administer the individual mandate.

 

6056-Applicable Large Employer (ALE)

Requires ALEs to provide full-time employees (FTEs) and the IRS with information regarding an offer of health plan coverage during the CY. Information in this report is used to administer the employer mandate.

 

FORMS

“B” Forms (1094-B and 1095-B)

-used by health insurance carriers, small employers with self-insured (level funded) health plans, and multiemployer plans to report individuals who had MEC in the CY

- 1094-B – Transmittal Form: cover page for submission of all forms 1095-B to the IRS

- 1095-B – identifies a specific individual’s (and any covered family member’s) health coverage

 

“C” Forms (1094-C and 1095-C)

-Used by ALEs to report offers of coverage to FTEs to satisfy the employer mandate and by self-insured ALEs to report MEC

-1094-C – Transmittal Form: cover page for submission of all forms 1095-C to the IRS

-1095-C – identifies each FTE and information regarding the offer of coverage; also provides information on employee/individuals and family members covered by the self-insured plan

 

Employer Reporting Obligations

EMPLOYER TO EMPLOYEE     

 

What Form/Parts?

To Whom?

When?

Insured, under 50 FTEs

No employer action. Carriers provide Form 1095B

No employer action. Carrier provides Form 1095B to covered individuals by January 31.

No employer action. Carrier provides Form 1095B to covered individuals by January 31.

Self-insured, under 50 FTEs

Form 1095B (all parts except II)

Covered individuals

January 31

Insured (or no coverage), 50 or more FTEs

Form 1095C (parts I and II)

All FTEs

January 32

Self-insured, 50 or more FTEs

Form 1095C (all parts)

All FTEs and all covered employees/individuals

January 31

                                                                                   

EMPLOYER TO IRS

 

What Form?

When?

Insured, under 50 FTEs

No employer action. Carriers obligation

No employer action. Carrier obligation

Self-insured, under 50 FTES

Form 1095B (transmittal form)

All forms 1095B

February 28 (April 2, if filing electronically)

Insured (or no coverage), 50 or more FTEs

Form 1095C (transmittal form)

All forms 1095C

February 28 (April 2, if filing electronically)

Self-insured, 50 or more FTEs

Form 1095C (transmittal form)

All forms 1095C

February 28 (April 2, if filing electronically)

 

Cosmo Insurance Agency is an independent insurance agency serving surrounding communities in New Jersey. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating the latest in technology-based tools and laws on healthcare, employee benefits, life insurance and finance, we keep our clients up-to-date with the plans that encompass all of their needs, whether it is individual or group insurance. 

CONTACT COSMO

Source: Emerson Reid

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